Provider Demographics
NPI:1134174675
Name:MUNOZ VARGAS, GRISSEL (MD)
Entity type:Individual
Prefix:MRS
First Name:GRISSEL
Middle Name:
Last Name:MUNOZ VARGAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1654 CALLE SANTA ANGELA
Mailing Address - Street 2:URB. SAGRADO CORAZON
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4111
Mailing Address - Country:US
Mailing Address - Phone:787-761-1719
Mailing Address - Fax:
Practice Address - Street 1:2020 AVE BORINQUEN
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00915-3822
Practice Address - Country:US
Practice Address - Phone:787-268-4171
Practice Address - Fax:787-727-3695
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11513208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics